Utah Spinal Health and Rehabilitation PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6089352-1202 Issued in UT

Legal business name

UTAH SPINAL HEALTH AND REHABILITATION PC

Practice address

205 N Main St
Spanish Fork, UT 84660-1726

Phone

(801) 798-2515

Fax

(801) 798-2510

NPI assigned

Aug 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brent Nephi Wall, DCNPI 1346263100

Title

President

Phone

(801) 798-2515

Specialties & licenses 1

Addresses

Other names 1

• Advanced Spinal Care Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brent N Wall, D.C

  • Chiropractor
  • Spanish Fork, UT
  • NPI 1346263100
  Medicare reassignment Care Compare group Authorized official
• Steven Earl Davis, D.C.

  • Chiropractor
  • Spanish Fork, UT
  • NPI 1770735284
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1386759454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N MAIN ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601726",
            "telephone_number": "801-798-2515",
            "fax_number": "801-798-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N MAIN ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601726",
            "telephone_number": "801-798-2515",
            "fax_number": "801-798-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH SPINAL HEALTH AND REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "NEPHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-798-2515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "6089352-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Spinal Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Spinal Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.